Bextra is a drug used to reduce inflammation and ease mild to moderate pain for such conditions as arthritis or painful menstrual cycles. Generic Bextra tablets are not available.

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HOW TO USE: Take bextra tablets by mouth. Follow the directions on the prescription label. Swallow tablets whole with a full glass of water; take tablets in an upright or sitting position. Taking a sip of water first, before taking the tablets, may help you swallow them. If possible, take bedtime doses at least 10 minutes before lying down. If bextra upsets your stomach, take it with food or milk. Take your doses at regular intervals. Do not take your medicine more often than directed.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

SIDE EFFECTS: Side effects that you should report to your prescriber or health care professional as soon as possible: signs of bleeding from the stomach - black tarry stools, blood in the urine, unusual tiredness or weakness, vomiting blood or vomit that looks like coffee grounds; signs of an allergic reaction - difficulty breathing or wheezing, skin rash, redness, blistering or peeling skin, hives, or itching, swelling of eyelids, throat, lips ; decrease in the amount of urine passed; difficulty swallowing, severe heartburn or burning, pain in throat; stomach tenderness, pain, bleeding, or cramps; swelling of feet or ankles; unexplained weight gain or edema; yellowing of eyes or skin.

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome): diarrhea; dizziness; gas; headache; heartburn; minor upset stomach; nausea or vomiting.

PRECAUTIONS: Let your prescriber or health care professional know if your pain continues; do not take with other pain-killers without advice. If you get flu-like symptoms (fever, chills, muscle aches and pains), call your prescriber or health care professional; do not treat yourself.

To reduce unpleasant effects on your stomach, take bextra with a full glass of water. Do not smoke cigarettes or drink alcohol; these increase irritation to your stomach and can make it more susceptible to damage from bextra. If you notice black, tarry stools or experience severe stomach pain and/or vomit blood or what looks like coffee grounds, notify your health care prescriber immediately.

Avoid taking other prescription or over-the-counter non steroidal anti-inflammatory drugs (NSIADs), such as ibuprofen (Advil?, naprosyn (Aleve?, or ketoprofen (Orudis?KT), while taking valdecoxib. Side effects including stomach upset, heartburn, nausea, vomiting or serious side effects such as ulcers are more likely if valdecoxib is given with other NSAIDs. Many non-prescription products contain NSAIDs; closely read labels before taking any medicines with bextra.

Bextra cannot take the place of aspirin for the prevention of heartattack or stroke. If you are currently taking aspirin for this purpose, you should not discontinue taking aspirin without checking with your prescriber or health care professional.

It is especially important not to use valdecoxib during the last 3 months of pregnancy unless specifically directed to do so by your health care provider. Bextra may cause problems in the unborn child or complications during delivery.

DRUG INTERACTIONS: ACE Inhibitors, often used to treat high blood pressure or heart problems; agents that treat or prevent blood clots, such as blood thinners; alcohol; alendronate; cyclosporine; drospirenone; ethinyl estradiol (Yasmin?; fluconazole; herbal products that contain feverfew, garlic, ginger, or ginkgo biloba; ketoconazole (products taken by mouth only); lithium; methotrexate; other antiinflammatory drugs (such as ibuprofen or prednisone); water pills (diuretics).

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

NOTES: Prescriber needs to know if you have any of these conditions: anemia; asthma, especially aspirin sensitive asthma; cigarette smoker; dehydrated; drink more than 3 alcohol-containing beverages a day; heart or circulation problems such as heart failure or leg edema (fluid retention); high blood pressure; kidney disease; liver disease; stomach bleeding or ulcers; taking blood thinners; taking hormones such as prednisone (steroids); an unusual or allergic reaction to valdecoxib, aspirin, other salicylates, other NSAIDs, sulfonamides, other drugs, foods, dyes or preservatives; pregnant or trying to get pregnant; breast-feeding.

MISSED DOSE: If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

STORAGE: Keep out of the reach of children in a container that small children cannot open.

Store at room temperature below 15-30 degrees C (59-86 degrees F). Protect from moisture. Keep container tightly closed. Throw away any unused medicine after the expiration date.

More information for Bextra:

Bextra is used to relieve: 

• symptoms of osteoarthritis and rheumatoid arthritis in adults 
• painful menstrual cycles   

Who should not take Bextra? 

You should not take Bextra if you: 

• had asthma, hives or allergic reactions after taking aspirin or other NSAIDs (nonsteroidal anti-inflammatory drugs) or COX-2 inhibitors. Some examples of NSAIDs are ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve), diclofenac (Voltaren, Cataflam), nabumetone (Relafen), ketoprofen (Orudis), celecoxib (Celebrex), and rofecoxib (Vioxx). You can ask your doctor or pharmacist for a complete list of these medications 
• are allergic to valdecoxib (Bextra) or to any of the ingredients in Bextra

Special Warnings with Bextra:

Bextra and all NSAID medications can cause stomach ulcers that bleed. The chance of this serious problem increases the longer you take Bextra, but it can also happen suddenly. Stop taking Bextra and call your doctor right away if you get: 

• a burning stomach pain 
• black bowel movements that look like tar 
• vomit that looks like blood or coffee grounds 

General Precautions with Bextra:

Bextra and other NSAID medications can cause serious problems such as liver damage. Some of the warning signs of liver damage are nausea, vomiting, tiredness, loss of appetite, itching, yellow coloring of skin or eyes, 揻lu-like?symptoms and dark urine. If this happens, stop taking Bextra and call your doctor right away. 

• Bextra can cause fluid retention (holding of water in your body). Fluid retention can be a serious problem if you have high blood pressure or heart failure. 

Do not use Bextra if you have asthma and are allergic to aspirin. If an aspirin-sensitive asthmatic takes aspirin it can cause severe narrowing of the airway (bronchospasm), and even death. The same reactions to aspirin and other NSAID medicines happened in aspirin-sensitive patients. 

What should I tell my health care provider?

Tell your health care provider if you: 

• have heart problems or high blood pressure 
• have liver or kidney problems 
• have or had stomach ulcers or stomach bleeding 
• have asthma 
• are allergic to aspirin or other NSAID medicines 
• are pregnant or planning to become pregnant 
• are breast-feeding 

Tell your health care provider about all the medicines that you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements. Your health care provider may have to adjust your dose or watch you more closely if you take the following medications: 

• certain blood pressure medicines called ACE inhibitors 
• furosemide (Lasix) 
• fluconazole or ketoconazole 
• lithium 
• warfarin (coumadin) 
• aspirin 

What are some possible side effects of Bextra? (This is NOT a complete list of side effects reported with Bextra. Your health care provider can discuss with you a more complete list of side effects.) 

Side effects can include: 

• Indigestion 
• Nausea 
•  Stomach pain 
• Upper respiratory tract infection 
• Diarrhea 
• Headache 

Rarely serious ulcers and stomach bleeding have occurred in patients taking Bextra. 

For more detailed information about Bextra, ask your health care provider or pharmacist.